摘要
目的研究近年来肠道门诊腹泻患者志贺菌菌群分布及其耐药特点,为细菌性痢疾临床治疗和预防控制提供依据。方法采用志贺菌及沙门菌琼脂培养基培养,可疑菌株经VITEK-32细菌鉴定仪及血清凝集鉴定到群,K-B法检测抗菌药物的耐药性。多重耐药菌用纸片确认试验检测产超广谱β-内酰胺酶(ESBLs),三维试验检测AmpCβ-内酰胺酶(AmpC酶)。结果 151株志贺菌中主要为宋内志贺菌(85株,占56.3%)和福氏志贺菌(64株,占42.4%),且感染患者主要集中在0～10岁年龄段,占总感染率的72.2%(109/151)。药敏结果显示,福氏志贺菌和宋内志贺菌对氨苄西林、氨苄西林/舒巴坦、哌拉西林和复方磺胺甲噁唑的耐药率较高,均>50%,对三代头孢及四代头孢的耐药率均在35%以下;福氏志贺菌对环丙沙星和左氧氟沙星的耐药率分别为29.6%和21.8%,未发现宋内志贺菌耐药者,且两者对哌拉西林/三唑巴坦和亚胺培南全部敏感。31株多重耐药菌经纸片确认试验均为ESBLs阳性菌株,但未发现AmpC酶阳性者。结论我院肠道门诊腹泻患者以感染宋内志贺菌和福氏志贺菌的婴幼儿为主,两种志贺菌对部分种类的抗菌药物药敏性差别较大,临床医师应根据菌群鉴定及药物敏感试验结果合理选择抗菌药物。
Objective To investigate distribution and antibiotic resistance of Shigella group causing diarrhea in patients in recent years for the guidance of clinical treatment and prevention and control of bacillary dysentery. Methods Suspicious strains isolated from Shigella and Salmonella agar culture were identified to the group by VITEK-32 instrument and serum agglutination of bacteria, and K-B method was used to study the antimicrobial resistance. Multiresistant strains were detected with the K-B methord to confirm producing extended-spectrum β-lactamases（ESBLs）, and three-dimensional test for detection AmpC β-lactamases （AmpC enzymes）. Results Among 151 strains of Shigella isolated, the most common groups were S. sonnei （87 striains, account for 56.3%） and S. fleaneri （64 strains, account for 42.4%）, and the most infected patients were 0 to 10 years old（account for 72.2% of the total infection rate, 109/151）. The results of antibiotic susceptibility test in vitro showed the resistance rates of S. fleaneri and S. sonnei to ampicillin, ampicillin/sulbactam, piperacillin and cotrimoxazole were higher than 50%, and to the third- and the fourth-generation cephalosporin were low than 35%. The resistance rates of S. fleaneri to ciprofloxacin and levofloxacin were 29.6% and 21.8%, respectively, and no S. sonnei isolates were resistant to ciprofloxacin and levofloxacin. In addition, no isolate was resistant to piperacillin/tazobactam and imipenem. Thirty one multiresistant strains were confirmed to be ESBLs positive, but not AmpC enzyme. Conclusion In the investigated hospital, the major patient groups infected by S. fleaneri and S. sonnei were infants and young children, and the sensitivity of the two kind of Shigella to some antibiotics varied greatly. Therefore, clinician should selected reasonably antibiotics according to the bacteria identification and drug susceptibility of Shigella.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2011年第4期311-314,共4页
Chinese Journal of Antibiotics
关键词
志贺菌
耐药性
产超广谱Β-内酰胺酶
Shigella
Distribution drug resistanc
Extended-spectrum β-lactanmses （ESBLs）
